In Cornerstone, the magazine of the National Legal Aid & Defender Association, Dan Mistak, COCHS' general counsel, explains how two tectonic shifts in the health care world have poised legal aid lawyers and defenders to better advocate for community solutions to client needs: the Medicaid expansion under the Affordable Care Act (ACA) and Section 223 of the Protecting Access to Medicare Act (otherwise known as the “Excellence Act”). Read more...

Too often individuals end up in the criminal justice system because of a lack of access to behavioral health care in their communities. The Excellence Act has the potential to change this cycle. Read more...

At the end of 2014, Community Oriented Correctional Health Services (COCHS) received funds from the Substance Abuse and Mental Health Services Administration to develop nine case studies on data-sharing between the criminal justice and the health care sectors to promote continuity of care.

Passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009 spurred an unparalleled investment in the nationwide adoption of health information technology. One of the chief aims of HITECH is to improve coordination and continuity of care through data-sharing.

Criminal justice and behavioral health care providers, however, have been passed over by this technological wave. We developed nine case studies as a way to provide insights from a range of jurisdictions and organizations and inform data-sharing efforts in other communities.

Historically, health care policy in the United States has not considered the special needs of individuals who cycle in and out of jails. The reason is obvious: consumer-oriented issues related to choice and protection have been the primary drivers of health care policy, and until very recently, few people in jail could afford health insurance. They were not consumers.

The ACA has expanded affordability of, and access to, health care and granted rights and responsibilities specifically to individuals in jail pending disposition. It is only a matter of time before correctional settings must incorporate the consumer-based insurance mechanisms and assurances established by the ACA. Recognition of serious, widespread deficiencies in the physical and mental health care services provided in jail underscores the urgency of this need. Download document...

In this paper, Dan Mistak, general counsel of COCHS, describes the history of federal financial participation (FFP) prohibitions on providing health care for individuals in public institutions and CMS’ current re-consideration of old FFP exclusions on funding for Institutions for Mental Disease ("IMD") in the face of the opioid abuse crisis. He also points out how removing prohibitions for IMDs, while retaining the ban on funding for certain types of inmate health care will exacerbate disparate racial impacts. This paper urges CMS to reconsider the “Inmate Exception” in the same way it reconsidered its IMD exception in order to ensure that everyone affected by the opioid epidemic receives treatment and to avoid the implicit devaluation of young, poor people of color. In order to create a fairer criminal justice system, we must ensure that everyone affected by the opioid epidemic is treated rather than incarcerated. Read more...

In order to create a fairer criminal justice system, we must ensure that everyone affected by the opioid epidemic is treated rather than incarcerated. Please send Victoria Wachino, Director of Medicaid and CHIP Services, an email urging her to consider a waiver for the inmate exception: click here to send email.

In California hundreds of criminal defendants declared incompetent to stand trial are sitting in county jails around the state awaiting transfer to state facilities for mental health treatment. Commenting on an ACLU lawsuit concerning this practice, Dan Mistak, COCHS general counsel,said the lack of treatment beds dates back decades to when California began deinstitutionalizing mentally ill people . . . “There hasn’t been a social safety net for these folks and what’s happened is the jail has actually stepped in in order to make up for essentially what’s been a lack of these services everywhere else,” Mistak noted. Read more...